Dietary isoflavone intake is associated with evoked responses to inflammatory cardiometabolic stimuli and improved glucose homeostasis in healthy volunteers

BACKGROUND AND AIMS

Consumption of foods that modulate inflammatory stress in genetically-prone individuals may influence development of cardiometabolic diseases. Isoflavones in soy-derived foods function as phytoestrogens, have antioxidant and anti-inflammatory activity, inhibit protein-tyrosine kinase activity, and may be atheroprotective. We examined the relationship between soy food consumption and inflammatory responses to endotoxemia, postprandial responses to oral lipid tolerance test (OLTT), and insulin sensitivity from frequently sampled intravenous tolerance tests (FSIGTT).

METHODS AND RESULTS

We administered low-dose endotoxin (LPS 1 ng/kg) to induce transient endotoxemia in young, healthy volunteers (N = 215) of African (AA), and European (EA) ancestry as part of the GENE Study. We further supported these findings in two independent samples: the MECHE Study and NHANES. Soy food consumption was a significant predictor of peak cytokine response following LPS. Individuals with moderate-high (>1.48 mg/day, N = 65) vs. low-no (<1.48 mg/day, N = 150) isoflavone consumption had significantly higher tumor necrosis factor alpha (TNFα) post-LPS (AUC, P = 0.009). Further, high-isoflavone consumers were protected against inflammation-induced decline in insulin sensitivity (SI) in GENE. We observed significant differences by soy consumption in the interferon gamma (IFNγ) response to OLTT, and the insulin response to OGTT in MECHE, as well as significantly lower fasting insulin, and 2-hour glucose post-OGTT in EA NHANES subjects.

CONCLUSION

We demonstrate that soy consumption may influence inflammatory and metabolic responses. In research of nutritional exposures, measuring evoked phenotypes may be more informative than describing resting characteristics. The GENE Study was registered under NCT00953667 and the MECHE Study under NCT01172951, both at clinicaltrials.gov.

Bacterial infective arthritis following a penetrating stick injury of the stifle joint in a dog

An eight-year old, Rottweiler was presented with a chronic non-weight bearing right pelvic limb -lameness and a discharging sinus at the right stifle joint. Fifteen weeks previously a diagnosis of bacterial infective arthritis had been made, presumed attributable to haematogenous spread. Failure to respond to appropriate surgical and medical management resulted in severe joint dysfunction. The poor prognosis for restoration of limb function resulted in limb amputation. Subsequent exploration of the sinus tract and the stifle joint revealed a stick within the craniolateral aspect of the joint. This penetrating stick injury had been responsible for the persistent bacterial infective arthritis.

Management of laterally displaced proximal tibial physeal fractures in three dogs

Fractures of the proximal tibial physis are uncommon in dogs, and are rarely associated with marked instability and lateral displacement of the proximal tibial epiphysis. Three dogs with proximal tibial physeal fractures demonstrating marked instability and lateral displacement were treated with two different principles of fixation. Healing of the physeal fracture was achieved with rigid internal fixation in one case, and with adaptational osteosynthesis supplemented with a temporary transarticular external skeletal fixator in two cases. Duration of surgery and technical difficulty was reduced using a modified adaptational osteosynthesis approach, suggesting that surgical treatment of these uncommon and challenging fractures may be more appropriately achieved by this technique.

Monitoring the role of aceticlasts in anaerobic digestion: activity and capacity

Aceticlastic methanogens are seen as a key to digester capacity and stability. This paper develops and applies an assay to measure digester stability by measuring the maximum aceticlastic methane production rate (Vmax,ac). The Vmax,ac in combination with acetate concentrations was found to be an effective digestion monitoring tool to indicate process upsets. At steady state, thermophilic, first stage and short SRT digesters generally had a greater Vmax,ac than mesophilic, second stage or long SRT digesters. The ratio of the Vmax,ac to the plant aceticlastic methane production rate, termed the Acetate Capacity Number (ACN), is a measure of the excess capacity of the digester. Either Vmax,ac or ACN can be used to estimate the capability to handle higher organic loading rates. Monod modeling was used to predict Vmax,ac, ACN and maximum VS loading rates for mesophilic and thermophilic digestion and for staged digesters to better understand expected digestion capacity and stability.

Performance and stability of two-stage anaerobic digestion

The stability, capacity, and solids destruction efficiency of single versus two-stage anaerobic digestion was studied in bench-scale reactors using combined waste activated and primary sludge. Laboratory staged mesophilic digesters showed an improved volatile solids and volatile suspended solids destruction efficiency over a single-stage system (at the same total solids retention time [SRT]) of approximately 3.2 and 5.8 percentage points, respectively. To quantify stability and capacity, a new digester monitoring method was introduced that measured the digester maximum acetate utilization capacity, V(max,ac), and was used to investigate the potential for digester instability at different transient loadings. The ratio of the V(max,ac) value to the estimated acetate production rate for a given digester loading was termed the acetate capacity number (ACN). Values greater than 1.0 indicate excess acetate utilization capacity. The first stage of the laboratory two-stage mesophilic system (10-day SRT for each stage) had an ACN number of 1.3 compared with a value of 1.8 for the single-stage 20-day SRT digester. Thus, while a staged mesophilic system can improve solids destruction efficiency, it demonstrates a lower capacity for metabolizing highly variable loads.

Use of the ADM1 to investigate the effects of acetoclastic methanogen population dynamics on mesophilic digester stability

The ADM1 was employed to assess the effect of variations in solids hydrolysis and acetoclastic methanogen process characterizations on municipal digester stability relating to excess acetate utilization capacity. First-order single- and dual-pathway hydrolysis rate functions and single and competitive acetoclastic methanogen rate functions were implemented in the ADM1. The acetate capacity number (ACN), defined as the ratio between the maximum acetate utilization rate and the average acetate production rate, was used to index digester instability. Simulations of a single CSTR at steady state indicate a similar ACN can be obtained with a 12-day SRT digester dominated by Methanosarcina sp and a 24-day SRT digester dominated by Methanosaeta sp. An increase in ACN with a decrease in SRT representing Methanosarcina sp. selection was observed for particulate feed loadings from 40 g COD/L to 90 g COD/L. Feeding frequency and dual-pathway hydrolysis were found to have less effect on the ACN than the competitive acetoclastic model structure.

Anaerobic transformations and bioremediation of chlorinated solvents

Chlorinated aliphatic compounds, notably the chlorinated solvents, are common contaminants in soil and groundwater at hazardous waste sites. While these compounds are often recalcitrant, under favorable conditions they can be transformed and degraded through microbially mediated processes. There is great interest in understanding the transformations that are observed at contaminated sites and in manipulating these systems to achieve remediation. An important class of transformations occurs in anaerobic environments. Many of the transformations are reductive, and many yield useful energy to specific anaerobic bacteria. They include reductive dechlorination, dehydrochlorination and dichloroelemination. Of these, reductive dechlorination is often a growth-supporting reaction, while the others may be abiological or catalyzed by biological molecules. The reactions may result in chlorinated products, but there are often reaction sequences leading to completely dechlorinated products. The behavior of carbon tetrachloride (CT), 1,1,2,2-tetrachloroethane (TeCA) and the chloroethenes, perchloroethylene (PCE) and trichloroethylene (TCE), illustrate the range of anaerobic transformations that are possible, as well as the limited transformation that often is seen in the environment. CT undergoes reductive and substitutive reactions that are catalyzed by biological molecules but do not support bacterial growth. The anaerobic degradation of TeCA, which is a major contaminant at a site near Tacoma, WA, USA, provides examples of each type of transformation, and the products formed are consistent with the chlorinated compounds that are found in groundwater extraction wells. A laboratory study, using anaerobic sludge that had been fed chlorinated compounds, a cell-free extract from the sludge, and killed controls, showed that TeCA was transformed to four products and that these were further transformed, suggesting that it might be possible to degrade TeCA to innocuous products. Reductive dechlorination of PCE and TCE has been studied in many laboratories. Studies with mixed anaerobic consortia and with several dehalogenating bacteria, including strain 195 (. Isolation of a bacterium that reductively dechlorinates tetrachloroethane to ethane. Science 276, 1568-1571) that transforms PCE to ethene, have demonstrated that reductive dechlorination supports growth of the novel bacteria that carry out the reactions. Hydrogen has been shown to be an electron donor for the bacterial dehalogenation reactions, and kinetic and thermodynamic considerations indicate that dehalogenators can compete in some, but not all, anaerobic environments, pointing to applications of in situ bioremediation and to its limitations. Selected field studies of anaerobic transformations help delineate the applications of this type of bioremediation.

Anaerobic transformation of 1,1,1-trichloroethane by municipal digester sludge

Anaerobic transformations of 1,1,1-trichloroethane (TCA), 1,1-dichloroethane (DCA), and chloroethane (CA) were studied with sludge from a lab-scale, municipal wastewater sludge digester. TCA was biologically transformed to DCA and CA and further to ethane by reductive dechlorination. TCA was also converted to acetic acid and 1,1-dichloroethene (11DCE) by cell-free extract. 11DCE was further biologically converted to ethene. This pathway was confirmed by transformation tests of TCA, DCA and CA, by tests with cell-free extract, and by chloride release during TCA degradation. With cell-free extract, acetic acid accounted for approximately 90% of the TCA transformed; tests with live cells indicate that the fraction of TCA transformed by this pathway decreased with lower biomass. The dechlorination of DCA to CA and CA to ethane was not stoichiometric. A high rate of TCA removal was observed under the experimental conditions. The results indicate that removal of TCA in anaerobic digestion should be complete, but DCA and CA could persist in a normally operating digester.

Thoracoscopic versus open partial pericardectomy in dogs: comparison of postoperative pain and morbidity

OBJECTIVE

To evaluate postoperative pain and morbidity in dogs undergoing open thoracotomy and partial pericardectomy versus thoracoscopic pericardectomy.

STUDY DESIGN

Research study in normal dogs.

ANIMALS OR SAMPLE POPULATION

Fourteen mixed breed healthy dogs.

METHODS

Seven dogs had a partial pericardectomy through a standard left lateral thoracotomy at the fifth intercostal space. The remaining seven dogs underwent selective lung ventilation and thoracoscopic partial pericardectomy. Surgery sites in both groups were bandaged and each dog received a single postoperative dose of morphine (0.2 mg/kg, intramuscularly [i.m.]). Postoperative pain was evaluated using a standard pain score table at 1, 5, 9, 17, 29, and 53 hours after surgery. Dogs receiving a pain score of six or greater received an additional dose of morphine. At each observation point, blood samples were taken to measure blood glucose and plasma cortisol concentrations. Pain scores, blood glucose, and plasma cortisol concentrations were compared between the two groups using two-way ANOVA.

RESULTS

Blood glucose concentrations, plasma cortisol concentrations, and pain scores were significantly different between the two groups, with the thoracotomy dogs having higher values at 1, 5, and 9 hours postoperatively. Three of the open thoracotomy dogs required additional analgesia after the initial dose of morphine. In addition, two dogs that underwent open thoracotomy were lame in the left forelimb and two others developed dehiscence of their wounds.

CONCLUSIONS AND CLINICAL RELEVANCE

Thoracoscopic partial pericardectomy has several advantages over open partial pericardectomy including decreased postoperative pain, fewer wound complications, and more rapid return to function.

Pentachlorophenol biodegradation kinetics of an oligotrophic fluidized-bed enrichment culture

A fluidized-bed reactor (FBR) was used to enrich an aerobic chlorophenol-degrading microbial culture. Long-term continuous-flow operation with low effluent concentrations selected oligotrophic microorganisms producing good-quality effluent for pentachlorophenol(PCP)-contaminated water. PCP biodegradation kinetics was studied using this FBR enrichment culture. The results from FBR batch experiments were modeled using a modified Haldane equation, which resulted in the following kinetic constants: qmax = 0.41 mg PCP mg protein-1 day-1, Ks = 16 micrograms l-1, Ki = 5.3 mg l-1, and n = 3.5. These results show that the culture has a high affinity for PCP but is also inhibited by relatively low PCP concentrations (above 1.1 mg PCP l-1). This enrichment culture was maintained over 1 year of continuous-flow operation with PCP as the sole source of carbon and energy. During continuous-flow operation, effluent concentrations below 2 micrograms l-1 were achieved at 268 min hydraulic retention time (tHR) and 2.5 mg PCP l-1 feed concentration. An increase in loading rate by decreasing tHR did not significantly deteriorate the effluent quality until a tHR decrease from 30 min to 21 min resulted in process failure. Recovery from process failure was slow. Decreasing the feed PCP concentration and increasing tHR resulted in an improved process recovery.

Triple pelvic osteotomy for the treatment of pelvic canal stenosis in a cat

A mature female domestic shorthaired cat with obstipation as a result of pelvic canal narrowing due to a pelvic fracture malunion was treated by triple pelvic osteotomy to widen the canal. The right hemipelvis was moved laterally and a modified bone plate was applied to the right ilium. A mild lick dermatitis occurred over the dorsum of the hind paw seven days postoperatively but resolved without treatment. The cat made an uneventful recovery without recurrence of the obstipation.

Fracture of the humerus after cancellous bone graft harvesting in a dog

A five-year-old male Shetland sheepdog underwent calcaneoquartal arthrodesis for instability of the proximal intertarsal joint. A cancellous bone graft was harvested from the proximal humerus and packed around the arthrodesis site. Twenty-four hours postoperatively the dog developed a non-weightbearing forelimb lameness. Clinical and radiographic examination revealed a fracture of the humerus through the hole used to obtain the graft. Surgical repair of the fracture led to an uneventful recovery.

Biodegradation of chlorophenols by mixed and pure cultures from a fluidized-bed reactor

An aerobic, continuous-flow fluidized-bed reactor was established with inoculum from activated sludge, and fed a mixture of 2,4,6-trichlorophenol (TCP), 2,3,4,6-tetrachlorophenol (TeCP) and pentachlorophenol (PCP) as the sole sources of carbon and energy for 2 years. Experiments with the enrichment were performed with material from the reactor. Later, degradation experiments were completed using pure cultures of bacteria that were isolated from suspended samples of the carrier biofilm. In batch-bottle bioassays, the reactor enrichment degraded PCP, TeCP and TCP both in mineral salts (MS) and tryptone-yeast extract-glucose (TGY) media. ortho-Methoxylated chlorophenols including 4,5-dichloroguaiacol (4,5-DCG), tetrachloroguaiacol (TeCG) and trichlorosyringol (TCS) resisted biodegradation by the enrichment both in MS and TGY media, whereas 5,6-dichlorovanillin (5,6-DCV) was readily transformed to an unidentified metabolite. Experiments with 14C labeled chlorophenols showed mineralization of 2,4-dichlorophenol (DCP) and 2,3,5-TCP to 14CO2 by the enrichment. Material from the suspended biofilm after continuous chlorophenol feeding for 2 years was inoculated onto TGY-agar plates, and showed predominantly two colony types accounting for over 99% of the total colony counts. The two colony types, were equal in abundance. Six Gram-negative, oxidase- and catalase-positive, nonfermentative small rods were isolated in TGY agar media supplemented with 10 mg/l of TeCP or PCP. All isolates formed colonies in TGY plus 150 mg/l of PCP. The isolates degraded TCP and TeCP but not PCP. In mixtures of isolated bacteria the rates of chlorophenol degradation were similar to those observed with individual isolates. Three isolates were identified as Pseudomonas saccharophila and three were an unidentified species of Pseudomonas.

Solid-state low-loss intracavity saturable absorber for Nd:YLF lasers: an antiresonant semiconductor Fabry-Perot saturable absorber

We introduce a new low-loss fast intracavity semiconductor Fabry-Perot saturable absorber operated at anti-resonance both to start and sustain stable mode locking of a cw-pumped Nd:YLF laser. We achieved a 3.3-ps pulse duration at a 220-MHz repetition rate. The average output power was 700 mW with 2 W of cw pump power from a Ti:sapphire laser. At pump powers of less than 1.6 W the laser self-Q switches and produces 4-ps pulses within a 1.4-micros Q-switched pulse at an approximately 150-kHz repetition rate determined by the relaxation oscillation of the Nd:YLF laser. Both modes of operation are stable. In terms of coupled-cavity mode locking, the intra-cavity antiresonant Fabry-Perot saturable absorber corresponds to monolithic resonant passive mode locking.

Thrombogenicity of a factor IX concentrate quantitated in a canine model

Dose-ranging studies with a batch of factor IX concentrate have been performed in a canine non-stasis model of thrombogenicity. Doses between 50 and 200 IU/kg were infused over a 30 min period, and beagles were found to be more sensitive than greyhounds with regard to subsequent alterations in haemostatic parameters over a 150 min period. In beagles we detected significant increases in plasma fibrin(ogen) degradation products and reduction in fibrinogen concentrations in a dose-related manner after infusion of factor IX concentrate over the range 50-150 IU/kg. Plasma fibrinopeptide A was the most sensitive marker of activation of coagulation with significantly increased levels after factor IX at 50 IU/kg compared with control infusions of albumin. Recovery of infused factor IX was similar to values reported in man. In these experiments, measurement of urinary fibrinopeptide A did not prove to be a useful indicator of thrombogenicity. In conclusion, the beagle non-stasis model will provide a sensitive method to quantify the unwanted thrombogenic activities associated with the use of high doses of certain factor IX concentrates.

Serial fetal blood sampling for the management of pregnancies complicated by severe rhesus (D) isoimmunization

Fifty-one pregnancies complicated by rhesus (D) isoimmunization have been managed by serial fetal blood sampling between 17 and 36 weeks gestation as an alternative to amniocentesis for delta OD453 measurements. In 36 pregnancies where the fetus was shown to be rhesus (D) positive and both measurements were made before any intrauterine fetal transfusions, the delta OD453 value gave misleading predictions on 13 of 63 occasions (21%). Fetal haematocrit estimations provided a direct assessment of the haemopoietic compensation occurring, but fetal bilirubin and albumin concentrations did not correlate directly with disease severity. It is proposed that pregnancies complicated by severe isoimmunization can be more precisely managed by serial fetal blood sampling for haematocrit estimation than amniocentesis for delta OD453 measurement thus avoiding unnecessary intervention or delayed treatment.

Prediction of severity of aortic stenosis: accuracy of multiple noninvasive parameters

PURPOSE

As newer non-medical techniques are developed to treat older patients with severe aortic stenosis, reliable noninvasive diagnosis of the condition will become increasingly important. For this reason, the accuracy of multiple noninvasive indexes for quantitation of the severity of aortic stenosis was evaluated, relative to catheterization-determined aortic valve area.

PATIENTS AND METHODS

To evaluate the accuracy of multiple noninvasive parameters in assessing the presence and extent of aortic valve narrowing, noninvasive and catheterization correlations of the severity of aortic stenosis were obtained on 121 occasions in 81 patients (mean age, 76 +/- 11 years). Forty patients had studies performed before and after valvuloplasty. Noninvasive studies included the time to one-half carotid upstroke and carotid ejection time, corrected for heart rate, measured from a carotid pulse tracing; M-mode echocardiographic aortic valve excursion; mean pressure gradient across the aortic valve assessed by Doppler technique; the ratio of the peak to mean pressure gradient by Doppler; and Doppler aortic valve area assessed using the following continuity equation: aortic valve area = A X V/V1, where A = left ventricular outflow tract area, V = peak left ventricular outflow tract velocity, and V1 = peak velocity in the aortic stenotic jet. Mean aortic valve gradients and area (calculated using the Gorlin formula) were also assessed at cardiac catheterization.

RESULTS

The correlations between the catheterization measurement of aortic valve area and the various noninvasive measurements were as follows: time to one-half carotid upstroke (r = -0.32, p less than 0.001); corrected left ventricular ejection time (r = -0.24, p less than 0.05); aortic valve excursion (r = 0.51, p less than 0.001); mean gradient by Doppler study (r = -0.44, p less than 0.001); mean gradient by catheterization analysis (r = -0.55, p less than 0.001); peak to mean gradient ratio measured by continuous wave Doppler (r = 0.38, p less than 0.001); and aortic valve area assessed using the Doppler continuity equation (r = 0.85, p less than 0.001).

CONCLUSION

Noninvasive determination of aortic valve area using the continuity equation is an accurate means of assessing the severity of aortic stenosis. Although multiple other noninvasive parameters also correlate with aortic valve area measured at catheterization, there is too much scatter of data points to permit accurate prediction of catheterization aortic valve area in any given patient.

Usefulness of noninvasive assessment of aortic stenosis before and after percutaneous aortic valvuloplasty

Noninvasive and catheterization studies were performed in 40 patients (mean age 76 +/- 12 years) before and after percutaneous aortic valvuloplasty. Measurements included time to 1/2 carotid upstroke, left ventricular ejection time, aortic valve excursion, mean aortic valve gradient and aortic valve area assessed using the continuity equation: aortic valve area = A X V/V1, where A = left ventricular outflow tract area, V = maximal left ventricular outflow tract velocity assessed by pulsed Doppler echocardiography and V1 = peak velocity in the aortic stenotic jet assessed using continuous-wave echocardiography. In addition, mitral regurgitation was assessed by pulsed Doppler mapping techniques. Mean aortic valve gradient, cardiac output and aortic valve area, calculated using the Gorlin formula, were determined at cardiac catheterization. There were significant correlations between Doppler and catheterization measurements of aortic valve area both before (r = 0.71, p less than 0.001) and after (r = 0.85, p less than 0.0001) valvuloplasty. The relations were demonstrated to be linear by F test and met criteria for identity. There were significant increases (all p less than 0.0005) after valvuloplasty in catheterization valve area (0.60 +/- 0.21 to 0.95 +/- 0.39 cm2), Doppler valve area (0.64 +/- 0.22 to 0.91 +/- 0.37 cm2), valve excursion (0.5 +/- 0.3 to 0.8 +/- 0.3 cm) and cardiac output (4.5 +/- 1.6 to 4.9 +/- 1.7 liter/min).(ABSTRACT TRUNCATED AT 250 WORDS)

Epidural empyema following thoracic extradural block. Case report

✓ An unusual case of epidural sepsis with subsequent paraparesis following the placement of a thoracic epidural catheter for the maintenance of a postoperative analgesic block is reported. The hazards of this technique are reviewed.